NPI | 1255473690 |
---|---|
Former Name | SUMMERLYN ROBIN DAVISSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 53204) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CO CSW-992722) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2009-12-01 |